Browsing by Subject "Clinical psychology"

Based on a biopsychosocial model of mammography pain, the current study assessed if specific biological and psychosocial factors were associated with higher reported mammography pain in early stage breast cancer survivors. One hundred and twenty-seven women completed questionnaires assessing demographic information, cancer treatment history, ongoing breast pain, mammography-related anxiety, and social support immediately prior to receiving a mammogram. They then completed questionnaires assessing mammography pain and mammography-related pain catastrophizing immediately following the mammogram. Using path modeling and mediation analyses, relations among these variables were examined. Results revealed that mammography-related pain catastrophizing was related to higher mammography pain directly, while ongoing breast pain, lower social support quantity, and lower perceived quality of social support related to higher mammography pain indirectly through mammography-related pain catastrophizing. Moderated mediation analyses found that the mediation effects of mammography-related pain catastrophizing were significantly different at varying levels of perceived quality of social support, with more pronounced negative effects for those with higher quality support than those with lower quality support. The theoretical, clinical, and research implications of these findings are discussed.

Effective emotion regulation plays an important role in psychological health. Two commonly-researched emotion regulation strategies are reappraisal, a cognitive change-based strategy, and mindfulness, an acceptance-based strategy. Although their potential in facilitating adaptive emotion regulation has been empirically demonstrated, little work has directly compared their cognitive and emotion regulatory effects, particularly in a symptomatic population. Using an analogue depressed sample, this study examined the relative effects of mindfulness and reappraisal in reducing sad mood and whether individual differences in trait mindfulness and habitual use of reappraisal moderated the effects. The study also compared the extent to which implementation of these strategies incurred cognitive resources and affected attitudes towards negative experiences. One hundred and twenty-nine participants were randomly assigned to receive training in mindfulness, reappraisal, or no training prior to undergoing an autobiographical sad mood induction. Following mood induction, participants rated their sadness on a visual analog scale before completing a Stroop test. Results showed that mindfulness and reappraisal were superior to no training, and equivalent in their effects in lowering sad moods. Compared to the mindfulness group, the reappraisal group reported significantly higher Stroop interference scores, reflecting greater depletion of cognitive resources. Higher trait mindfulness predicted greater reductions in sadness in the reappraisal group, but not in the mindfulness group. Habitual reappraisal did not moderate the effects of either mindfulness or reappraisal. Mindfulness, relative to reappraisal or no training, resulted in significant increases in acceptance of negative experiences and decreases in maladaptive beliefs about rumination. Overall, the study suggests that although mindfulness and reappraisal are equally effective in down-regulating sad mood, they incur different levels of cognitive costs and lead to differential changes in attitudes towards negative experiences.

Children and adolescents with sickle cell disease (SCD) are at high risk for medical complications, neuropsychological sequelae, and lower overall quality of life. One target of intervention that can positively impact these outcomes is treatment adherence. Despite the known benefits of treatment adherence for health outcomes, children with SCD encounter several barriers that result in low overall levels of adherence and reduction of treatment benefits. Furthermore, little is known regarding the relationship between adherence and quality of life for this pediatric population. As such, two studies were conducted in order to (a) examine the relationship between treatment adherence and quality of life among youth with SCD, and (b) examine the feasibility, acceptability, and preliminary efficacy of a novel mobile health intervention to improve adherence among youth with SCD. For the first study, 46 children and adolescents with SCD and a caregiver were recruited. Results indicated that participants with good adherence had significantly higher parent-reported quality of life than participants with poor adherence. In contrast, based on child self-report, participants did not differ across quality of life domains. Subsequently, 43 participants were recruited to participate in the pilot intervention study, the Intensive Training Program (ITP). The intervention was conducted in two phases: Phase I recruited participants receiving iron chelation therapy to reduce the risk of iron overload associated with chronic red blood transfusions (n=11); Phase II broadened the scope of participants to those prescribed hydroxyurea (HU; n=32), a once daily oral medication. Results indicated that patients and their caregivers endorsed high levels of acceptance, ease of use, and satisfaction with mobile health technology. In addition, participants encountered several technological issues that limited access and resulted in poor compliance with the ITP for some participants early on in the study. Despite this, participants demonstrated significant increases in medication possession ratio (MPR) based on pharmacy refill as well as sustained improvements in disease knowledge. Adherent participants demonstrated significant decreases in outcomes related to caregiver burden as well as significantly lower pain impact when compared to non-adherent youth. In addition, children who were adherent reported quality of life and overall SCD-related functioning at a clinically-significant higher level when compared to those who were non-adherent. Implications for future research and application to clinical care are discussed.

In the present study, we examined the predictions of an attentional-associative model (Schmajuk, Lam, & Gray Journal of Experimental Psychology: Animal Behavior Processes, 22, 321-349, 1996) regarding the effect of attentional manipulations on both discrete and contextual conditioned inhibitors.

The SLG model assumes that non-reinforced presentations of an inhibitory conditioned stimulus (CS) do not decrease its inhibitory associations. However, the model predicts that extended presentations will decrease attention to the inhibitor, thereby, decreasing both the expression of its inhibitory power in a summation test and the rate of acquisition in a retardation test. The model also predicts that subsequent presentations of the inhibitory CS with a novel CS will increase both its inhibitory power in a summation test and the rate of acquisition in a retardation test. Using a predictive learning design in humans, Experiment 1 examined the predictions involving the summation tests, whereas Experiments 2 and 3 examined the predictions involving the retardation tests. Experimental results were in agreement with the predictions of the model.

The SLG model also predicts that a salient extinction context (CX) becomes inhibitory and prevents extinction of the excitatory CS-unconditioned stimulus (US) association. Although some data seem to contradict that prediction (e.g., Bouton and King, 1983, Bouton and Swartzentruber, 1986, 1989), Larrauri and Schmajuk (2008) indicated that the CX might not appear inhibitory in a summation test because attention to the CX decreases with many but not few extinction trials. In a human predictive learning experiment, we confirmed the model's predictions that the inhibitory power of the extinction CX can be detected after a few extinction trials when attention to the CX is still high, but not after many extinction trials once attention to the CX has decreased (Experiment 4), and even after many extinction trials by presenting novel CSs to increase attention to the unattended CX (Experiment 5). Furthermore, using an eye-tracker, we confirmed the model's explanation of Experiment 4 results by showing decreased overt attention to the CX after many but not after few extinction trials (Experiment 6).

Importantly, the view that the extinction CX becomes inhibitory allows the model to explain spontaneous recovery (because attention to the excitatory CS increases before attention to the inhibitory CX), renewal (because the inhibition provided by the extinction CX disappears), and reinstatement (the inhibitory CX becomes neutral or excitatory), as well as a very large number of other experimental results related to extinction. Based on the prediction of the SLG, model the implications of our results for the treatments of anxiety disorders were discussed.

Substance use disorders are one of the most common psychiatric diagnoses among adolescents; marijuana is the illicit drug used most frequently by youth. Treatment dropout and relapse following treatment are common; innovative strategies are needed to improve treatment outcomes for youth substance abusers. The aim of this study was to develop and evaluate the feasibility of a virtual reality (VR) cue reactivity paradigm for adolescent cannabis abusers and to compare it to a video cue reactivity paradigm. Forty-two treatment-seeking youth with a cannabis use disorder completed the study, which incorporated three parts. During Part 1, drug and neutral video clips were shown to 11 youth and five substance-abuse experts who provided craving/usefulness ratings for each video clip. During Part 2, five youth met in a focus group and then individually to provide input on the development of the VR paradigm. During Part 3, 26 youth completed a laboratory procedure involving neutral and drug-related video clips and VR presentations. Heart rate, skin conductance, and skin temperature were measured as well as craving. Higher levels of craving and skin conductance were observed during drug-related presentations. The presentations did not significantly differ in their ability to elicit craving and arousal. Results suggest that youth can experience subjective and physiological reactivity to VR drug cues warranting further study with a larger, more diverse sample. Implications are discussed.

Utilizing data from The National Longitudinal Study of Adolescent Health (Add Health), the current study examined the relationship between cultural values, coping behavior, and HIV risk behaviors among African-American/Black and Hispanic/Latino adolescents (N = 437). The goal of this research was to provide the first step towards testing the construct validity of a theoretical model in which values and cultural context contribute to coping behaviors and coping, in turn, mediates the association between values and HIV risk profile. African-American participants endorsed higher levels of Africentric and religious values than did Hispanic participants and endorsed higher utilization of religious coping. Cultural values including familismo and religiosity were associated with more adaptive coping behavior and lower sexual and substance use risk behaviors across racial/ethnic groups. Results for other cultural values were inconsistent. Coping behavior predicted substance use risk behaviors but was not associated with sexual risk behaviors. Mediation was not supported except in the case of religious coping and religiosity. Implications for HIV prevention and directions for future research are discussed.

There is increased need for mental health support on college campuses: existing campus resources are increasingly unable to meet the mental health needs of their undergraduate communities. There is also increased preference from students for some forms of emotional support to come from peers. Peer support programs, in which students act as supportive listeners towards their fellow students, are increasingly common on college campuses, but the uptake and utility of these programs is not routinely examined. There is also a need to ensure that the mental health of students providing support is protected. Providing support for peers can be a positive source of meaning and life purpose, but also a source of perceived stress, emotional exhaustion, and, potentially, burnout. If such programs are to be developed and disseminated, it is critical to understand the mechanisms whereby communicating with a peer in a moment of distress can improve mental health outcomes. This dissertation aims to address the critical need of identifying key components for sustainability by providing an updated review of the prevalence and nature of existing undergraduate peer support programs (Study 1), synthesizing research on the impact of providing peer mental health support (Study 2), and evaluating the acceptability and feasibility of a novel text-based peer support program with a sample of undergraduates (Study 3). We found that approximately 10% of institutions affiliated with the American College Health Association have a peer program dedicated to supporting student mental health. Moreover, there has been a recent surge of interest in these programs: over 50% of programs identified were founded in the last 10 years. However, there is limited data collection and even less peer-reviewed research on the impact of these programs for the students receiving and providing support. DukeLine, an innovative text-based peer support program, was designed, implemented, and assessed for sustainability. Peer coaches were trained through a for-credit, semester-long course taught within the Department of Psychology and Neuroscience and committed to providing peer support in two-person shifts for two semesters while enrolled in a practicum course with weekly group supervision. No coach reported experiencing significant emotional exhaustion and, on average, coaches report deriving moderate levels of meaning and purpose from their role as a peer coach. Over a quarter (29.73%) of students who reached out to DukeLine for support did so more than once and 88.89% of texters reported feeling extremely satisfied with the support they received. DukeLine offers a sustainable model for peer support programs targeting undergraduate mental health that is acceptable and feasible, for students who seek and provide support.

Psychological treatments delivered by lay counselors, individuals with little or no previous mental health training, have been shown to be effective in treating a range of mental health problems. However, in low resource settings, the dearth of available experts to train and supervise lay counselors is a key bottleneck in scaling up lay counselor delivered psychological treatments. Locally sustainable solutions that allow experts to train and supervise large volume of lay providers are needed. Two proposed solutions include the use of digital health strategies and peer supervision. In study one, we used a human-centered design approach to develop a web application to support asynchronous clinical supervision of lay counselors providing a family therapy program in Kenya. The development process engaged seven previously trained lay counselors and three prior supervisors in a phased design process which resulted in a final application prototype, “REACH”, that supported audio and text communication via a chat and a structured session report form. In study two, we conducted a feasibility study with 30 counselors with the aim of describing the capacity of REACH support supervision practices, exploring the feasibility and acceptability of REACH compared to peer group supervision, and describing the treatment fidelity and clinical competency of a small group of counselors using REACH. REACH was perceived as highly acceptable from both peers and supervisors and demonstrated promising impacts on counselor fidelity and clinical competency. Content analysis of correspondence between the counselors and the superior via the REACH indicated the supervisor was able to implement a wide range of evidence-based supervision strategies. Limitations of bi-directional communication on potential supervision effectiveness are discussed. Overall, this project suggests digital asynchronous clinical supervision holds promise as a scalable method of clinical supervision in low-resource contexts.

Regular pelvic exams in the first two years after completing cancer treatment are critical for early detection of endometrial and cervical cancer recurrence. Gynecologic cancer survivors often report high levels of anxiety, pain and discomfort during this procedure. Despite increased attention to screening for distress during cancer treatment and follow up appointments, no interventions currently exist to support patients in coping with this recommended procedure. This dissertation aims to address this gap in health services research.The first study involved conducting in-depth individual interviews with gynecologic cancer patients (N=13) and interdisciplinary oncology providers (N=10) to explore patients’ experiences of distress associated with pelvic exams and intervention needs and preferences. The intervention development process is described including the development of a conceptual model, qualitative data collection and analysis, and the resulting content of each intervention session. Findings suggested that patients experience several types and sources of distress related to surveillance pelvic exams. Patients expressed interest in psychosocial support for managing anxiety related to pelvic exams. Patients and providers reported that a proposed brief telemedicine cognitive behavioral skills-based intervention targeting anxiety and pain related to pelvic exams would be acceptable and feasible. These findings informed the development of the PEACE intervention (Pelvic Examination and Anxiety Coping skills for Empowerment). The second study was a proof-of concept pilot study conducted with a quasi-experimental, within-subject design (N=16) to evaluate the acceptability and feasibility of the coping skills intervention and patterns of change in anxiety and pain symptoms. Mixed methods approaches were used. Participants (n=14) completed the 3-session telemedicine delivered coping skills intervention, completed assessments at baseline, post-intervention, and post pelvic exam, and completed a feedback interview. Findings suggested high overall acceptability and feasibility of PEACE. While the PEACE proof of concept trial was not powered to detect significant changes across time, patterns of change suggest promising results. While state anxiety during exams increased over time, the single-item measures of anxiety, fear and embarrassment indicated statistically significant decreases in distress over time. Participants demonstrated significant decreases in fear of recurrence after the intervention that were maintained after the follow up exam. Trends in patterns suggest that pain and discomfort severity decreased as well, though those changes were not significant. Self-efficacy for tension release and mindful attention significantly increased from pre- to post- intervention and generally remained high. Participants reported increased use of CBT skills and all reported they would use the skills in the future. Self-efficacy for communicating with providers and use of communication skills use did not follow a uniform pattern. Results suggest that a brief CBT intervention can reduce psychological distress, and may be suitable for implementation in collaborative care settings. Findings also indicate that patients with psychosocial stressors may benefit from flexible intervention delivery (i.e., phone sessions, booster sessions) and that adding a provider sensitive practice training component to PEACE may help strengthen the effects of the communication skill in particular. PEACE responds to a great need for evidence based, trauma-informed OB/GYN interventions and is well suited for further efficacy and implementation testing in the future.

The overarching goal of this study is to enhance the current understanding of how college students with disordered eating experience alcohol. The study focuses on negative consequences, drinking behaviors, alcohol expectancies, and outcomes to a high-risk drinking prevention program. Taking a novel perspective to examine these problem behaviors, the current study uses a national sample of college students (N=8,095) who participated in an internet-based alcohol prevention program (AlcoholEdu for College, www.outsidetheclassoom.com). Multiple multivariate analyses were conducted. The results found that male and female college students with disordered eating are a high-risk drinking population. They reported higher rates of binge drinking, experienced more negative alcohol consequences, and engaged in more risky drinking behaviors and less protective drinking behaviors than college students without disordered eating. Additionally, most but not all, college students with disordered eating endorsed higher alcohol expectancies. College students with mild disordered eating also reported slightly worse outcomes to the program than students without disordered eating. The results suggest that college students with disordered eating should be targeted as a high-risk drinking population.

Theories of self-regulation address the continuous process in which individuals compare their behavior to salient goals or standards. Two well-known theories of self-regulation, self-discrepancy theory (SDT) and regulatory focus theory (RFT), each make distinctions regarding the types of standards and goals in reference to which individuals self-regulate. Authenticity--the idea of being one's true self--has the potential to influence the kinds of goals or standards that individuals come to possess and may have implications for understanding the outcomes of self-regulatory processes. This research links the construct of authenticity with SDT and RFT, emphasizing how individual differences in authenticity could influence the motivational and affective consequences of self-regulation predicted within each theory. Individual differences in authenticity were expected to influence the nature of the goals and standards that individuals hold, as well as the acute and chronic affective consequences of discrepancies between the actual self and the ideal and ought self-guides respectively. Specifically, individual differences in authenticity were expected to predict magnitude of actual:ideal and actual:ought self-discrepancy as well as the intensity of distress that individuals report (acutely as well as chronically) in association with self-discrepancies. More importantly, self-discrepancies were expected to be less prevalent among individuals high in authenticity, but more distressing among high-authenticity individuals than among individuals with lower levels of authenticity. The results of this research suggest that individual differences in authentic behavior do have a direct influence on both acute and chronic affect. Authenticity was found to interact with self-discrepancies in predicting chronic affect. Authenticity has a unique role in the process of self-regulation, distinct from the contributions of SDT and RFT.

Attention is considered a fundamental component of mindfulness and current theory suggests that it is a primary mechanism of change that contributes to the substantive improvements in physical and psychological functioning attributed to mindfulness-based interventions including Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT). Using the Attention Network Test (ANT) and an Inattentional Blindness (IB) task, the current study assessed differences in subsystems of attention in a group of experienced MBSR practitioners and a group of meditation naïve controls. MBSR practitioners demonstrated superior conflict monitoring performance relative to the control participants; however, groups did not differ with regards to their performance on the alerting and orienting components of the ANT. Additionally, although the MBSR practitioners were nearly half as likely as their control counterparts to evidence IB, this difference was not significant. Finally, self-reported mindfulness was higher in meditators relative to meditation naïve control participants, though scores did not correlate with performance on the attention tasks. The implications of these findings and directions for future research are discussed.

The effect of Mindfulness Based Stress Reduction (MBSR) training on experimental measures of attention and emotion regulation was assessed. Two laboratory based measures of attention and emotion regulation were employed. Amongst a number of hypotheses, the effect of MBSR on return to emotional baseline was assessed. Analyses indicated that MBSR training had no effect on physiological indices of emotion regulation. Self-report measures indicated that MBSR training led to faster return to baseline negative emotional experience following a stressor. Implications and future directions are discussed.

The current study tested the effects of a brief, behavioral intervention for problems with emotion perception, the ability to perceive other people’s emotions, across a range of psychiatric disorders. The intervention was delivered through an in-person training session in which participants learned a mindful breathing skill, followed by a testing phase in which participants received phone-based reminders to practice the skill for one week. A sample of 80 adults with self-reported emotion regulation difficulties was recruited for this study and was randomized to either the Mindful Breathing condition, a Habituation condition, or a Control condition. Findings from this study suggested that, in the training session, participants in the Mindful Breathing condition had higher accuracy for perception of positive emotions and lower accuracy for perception of negative emotions than the control condition at the second and third timepoints. After the week of receiving phone reminders, participants in the mindful breathing condition had lower accuracy for perception of negative emotions than the control condition. Findings also suggest that the mindful breathing intervention reduces distress, which was associated with emotion perception performance. Therefore, this study’s findings provide preliminary evidence for a method of targeting emotion perception deficits that are associated with many psychiatric disorders. By combining both in-person and digital treatment components, this intervention also provides a feasible and effective complement to mainstream mental health services.

The scope of my dissertation project was to investigate the training of community leaders, including religious leaders, in the delivery of individual cognitive-behavioral support for depression in the community from Burma in NC. My research aims were to train community leaders a) to recognize the signs and symptoms of depression and associated problems, including intergenerational conflict, substance abuse, domestic violence and suicide; b) to use reflective listening and cognitive-behavioral therapy (CBT) skills, and c) to increase awareness of stigma toward treatment-seeking for depression and its related problems. Positive training outcomes were found for knowledge of depression and CBT strategies, and for attitudes toward treatment-seeking for depression; suggesting community leaders could be a valuable resource for expanding evidence-based mental health services delivery within the community from Burma and potentially within Burma as well, where there is a scarcity of mental health professionals. This study extends existing research on training paraprofessionals and religious leaders in the use of CBT. In particular, it adds to the knowledge base on providing mental health services within the community from Burma, which may extend to other refugee and immigrant communities in the U.S.

Among some researchers, there is an emerging conceptualization of chronic tic disorders (CTDs) as conditions that are partially rooted in avoidance of tic-related private experiences (i.e., painful or difficult thoughts and feelings) and internal sensations (i.e., premonitory urges to tic). The first specific aim of the present research was to investigate the possibility that experiential avoidance is related to tic severity and perceived quality of life in individuals with CTDs. The second aim was to determine whether the efficacy of Habit Reversal Training (HRT), the most prevalent and effective behavioral intervention for CTDs to date, might be enhanced by combining it with Acceptance and Commitment Therapy (ACT), an intervention that directly targets experiential avoidance. These aims were addressed by conducting two related studies. Study I, an online survey, included 239 adults (M = 37.6 years; SD = 13.8 years) who reported having been previously diagnosed with a CTD. Results showed that levels of premonitory urges, as well as both general and tic-specific experiential avoidance, were significantly positively related to tic severity. General and tic-specific experiential avoidance were also significantly negatively related to perceived quality of life. Psychometric analyses of two novel measures developed for Study I (i.e., the Yale Global Tic Severity Scale-Self-Report Version and the Acceptance and Action Questionnaire-Tic-Specific Version) demonstrated excellent internal consistency and convergent validity. Study II, a multi-site pilot investigation, involved 13 adolescents (M = 15.4 years; SD = 1.3 years) who were treated with either HRT alone or a novel HRT+ACT intervention. Results suggest that the HRT+ACT treatment is feasible, highly acceptable to both patients and parents, and as effective as HRT alone at reducing tic severity from pre-treatment through week 22 follow-up. Participants in both groups reported clinically significant post-treatment decreases in general and tic-specific experiential avoidance and improvements in overall functioning. Researchers concluded that experiential avoidance plays an important role in tic expression and overall functioning for individuals with CTDs. Results support additional development and testing of the promising HRT+ACT intervention, to evaluate its efficacy alone and in comparison to other relevant psychosocial and pharmacological interventions.

Many cost-effective, evidence-based developmental programs (EBPs) remain inaccessible to children in need. To improve access to care, this dissertation theoretically and then empirically examines different approaches to advocating for dissemination funding in a polarized political context. Section 1 describes recent advances in the use of morally framed messaging to change attitudes. Section 2 reviews research on political polarization with an emphasis on how polarization affects online message processing. Section 3 describes a theoretically informed EBP advocacy strategy that seeks to tailor and target advocacy messages to promote bipartisan support for EBP dissemination.

Sections 4, 5, and 6 describe three studies designed to test whether motivated social cognition (Jost, Glaser, Kruglanski, & Sulloway, 2003) or moral foundations theory (Graham, Haidt, & Nosek, 2009) may be used to tailor message frames to speak to the distinct needs of Liberals and Conservatives. In Section 7, results and limitations are discussed. Although the three studies provide limited support for the hypothesis that theory can be used to design persuasive, tailored messages, message frames were consistently overwhelmed by competition from partisan cues and ideological arguments. The dissertation concludes by arguing that, in order to generate bipartisan support for EBP dissemination, implementation funding and structures that are already highly prioritized by Liberals need to be designed to appeal to Conservatives’ substantive policy preferences.

Exposure to psychosocial stress is a robust predictor of subsequent psychopathology. However, only a portion of individuals with these experiences will develop psychiatric symptoms. The concept of gene-environment interaction (GxE) has provided one theoretical framework for reconciling these observations, but the empirical findings from this literature are mixed and often fail to replicate across studies. This dissertation explores the use of a relatively new approach to measuring the mental-health effects of environmental stress (the “p-factor”), and examines whether this approach has the potential to advance and consolidate studies of gene-environment interaction and psychopathology. First, I present lifetime prevalence data from The Dunedin Multidisciplinary Health and Development Study indicating that mental disorder is near-ubiquitous, consistent with the notion that liability to these conditions is distributed quantitatively throughout the population. Second, I present analyses from the Environmental Risk Longitudinal Twin Study showing that the mental-health effects of victimization exposure (one of the most common and severe types of psychosocial stress) are both non-specific and likely causal. These data suggest that stressful life experiences increase risk of psychopathology largely through effects on general liability. Third, I examine whether victimization’s effects on general psychopathology vary as a function of multiple measures of genetic propensity. Results consistently indicate that they do not, suggesting minimal gene-environment interaction. Implications for future research that seeks to identify the genetic and non-genetic factors that determine vulnerability and resilience to the mental-health effects of environmental stress are discussed.

Infertility affects approximately 12.5% of U.S. women and is often accompanied by psychological distress. The following study aimed to assess the relationship of modifiable psychological factors on depression and anxiety symptoms and posttraumatic growth in women experiencing infertility. Women (n=457) in the U.S. completed an online survey containing demographic and clinical information as well as standardized self-report measures of mindfulness (FFMQ-24), self-compassion (SCS-SF), positive affect (mDES), intolerance of uncertainty (IUS-SF), relationship satisfaction (CSI-4), experiential avoidance (AAQ-II), depression (PROMIS Depression 8b), anxiety (PROMIS Anxiety 8a) and posttraumatic growth (PTGI). Efforts were made to recruit Black and Latina women who are less likely to seek medical treatment for infertility and are often underrepresented in infertility research. The final sample included women who identified as Non-LatinX White (65%), Non-LatinX Black (13%), LatinX (16%), Asian (2%) and Other (4%). Clinical and demographics characteristics (age, duration trying to conceive, history of miscarriage, and childlessness) did not significantly predict depression or anxiety. Positive affect and experiential avoidance predicted depression and anxiety, self-compassion predicted depression, and intolerance of uncertainty predicted anxiety. There were also indirect effects of mindfulness on anxiety and depression via these variables. Counter to expectations, posttraumatic growth was associated with higher intolerance of uncertainty and experiential avoidance. This suggests that, measured cross-sectionally, perceiving growth may act as a palliative strategy to reduce distress for women currently experiencing infertility. This cross-sectional study provides preliminary evidence that interventions targeting experiential avoidance and positive affect may help to address depressive and anxiety symptoms in women experiencing infertility. In addition, offering skills to promote mindfulness may have beneficial downstream effects on other key coping variables. These effects should be evaluated in further clinical research.